My son Dan was in college, and by the time I arrived at his dorm, he had not eaten in more than a week. He was spending hours at a time sitting in one particular chair, hunched over with his head in his hands, doing absolutely nothing. He could not enter most of the buildings on campus and could only do minimal amounts of work at specific times. To top it all off, he was self-injuring. My son was in the throes of severe OCD.

This study uses functional magnetic resonance imaging (fMRI) to learn how the brain functions in adolescents receiving fluoxetine (Prozac) or cognitive behavioral therapy (CBT) for anxiety or depression in children/adolescents. All participants will receive interviews to assess how they are doing in general, including his or her general mood, degree of nervousness and behavior. Each participant and one of his or her parents will be interviewed separately and together.

IQ: All subjects will have IQ greater than 70 (Assessment relies on WASI)

SUBJECTS WITH AN ANXIETY DISORDER

Diagnosis: Current Diagnosis of Social Phobia, Separation Anxiety, or Generalized Anxiety Disorder (Based on K-SADS)

Symptom Severity: Score greater than 9 on PARS (This score was used to enroll subjects in previous trial demonstrating efficacy of an SSRI in pediatric anxiety.)

Clinical Impairment: CGAS less than 60

SUBJECTS WITH A MOOD DISORDER

Diagnosis: Current Diagnosis of Major Depression (Based on K-SADS (juveniles) or SCID (adults))

Clinical Impairment: CGAS less than 60 (juveniles) GAS less than 70 (adults)

Symptom Severity: CDRS Score greater than 39 (juveniles) (This score was used to enroll subjects in previous trials demonstrating efficacy of an SSRI in pediatric depression.)

ADULT SUBJECTS

Age: 20-40

Consent: Can give consent/assent.

IQ: All subjects will have IQ greater than 70. Assessment relies on WASI.

Exclusion Criteria:

ALL SUBJECTS:

Any serious medical condition or condition that interferes with fMRI scanning, and for patients electing medication, any condition that increases risk of SSRI treatment. All patients will have complete physical examination. Healthy volunteer participants will be medication-free and have no current serious medical conditions, based on a review of their medical history.

Pregnancy

Current use of any psychoactive substance; current suicidal ideation; current diagnosis of attention deficit hyperactivity disorder (ADHD) of sufficient severity to require pharmacotherapy. These factors could complicate treatment with an SSRI. No subject on medication will be accepted into the trial. Subjects will not be taken off of medications to enter the trial.

Past or current history of mania, psychosis, or pervasive developmental disorder. These factors may be effected by SSRI treatment, influencing ability to detect effects on anxiety/depression

Recent use of an SSRI: All subjects must have been free of any SSRI use for at least one month (fluoxetine six months) and must not have been treated with an SSRI for their current depressive episode. This is designed to exclude subjects who have failed a trial of an SSRI for their current episode of major depression.

Cynthia M. Bulik, PhD, FAED William and Jeanne Jordan Distinguished Professor of Eating DisordersDepartment of PsychiatryUniversity of North Carolina at Chapel Hill School of MedicineProfessor of Nutrition in the Gillings School of Global Public HealthDirector of the UNC Eating Disorders Program

Contact ADAA

ADAA is a national nonprofit organization dedicated to the prevention, treatment, and cure of anxiety, depression, OCD, PTSD, and related disorders and to improving the lives of all people who suffer from them through education, practice, and research.